Page 46 - Journal of Special Operations Medicine - Fall 2016

of injury, such as to skin and nerve. Unlike the TPTs, of metric usefulness is indicated, in turn, to better un-
the EMT has a bladder length that automatically tailors derstand how to improve survival rates by improving
to fit the specific portion of the limb to which it is ap- user performance. User-tourniquet specificity may be
plied. Additionally, there is no overlap of the bladder, scientifically developed for preference of model strati-
overlapping risks are eliminated, comfort is maximized fied by different roles of varied users, and the statistical
through shear minimization, and risk of tissue damage analysis of user effects, uncommon in first aid research
is minimized. Furthermore, the length of the bladder today, is recommended to become more common so that
when inflated is less than that of the inflated volume, science can be used to guide improvements in user per-
the count of pumps required for inflation is less, and the formance. Last, field assessments by representatives of
welds further minimize volume of inflation, thereby re- intended users, such as US Army Ranger medics, can
ducing the pump count required. Altogether, these traits be performed to further validate the present findings,
lessen the time of inflation. Simpler design (i.e., less tan- and such assessments may carefully look at user per-
gling of bands, no inadvertent Velcro contact), safer fit, formance and, if such performance is satisfactory, user
and faster effectiveness (i.e., fewer bands to route, faster preference of model.
inflation) would be expected to reliably produce good
outcomes and, in this study with EMT, such results were Funding
found.
This project was funded by the Defense Health Program
Tourniquet users vary by their individual setting, per- (Proposal D 6.7 R.0011884.4.14: Joint Operational
sonal prior training, and their acquired skill set, so the Evaluation by US Military Service Persons for Extremity
devices they use and prefer would naturally also tend to Tourniquet Use in Simulated Out-of Hospital Care).
vary by user, setting, training, and skill set. Experienced
stewards of tourniquet programs do not expect one tool Disclaimer
to fit every place, worker, and job; to date, no tourni-
quet model has been shown to be optimal or fit for all. The opinions or assertions contained herein are the pri-
Pneumatic devices are a better match for the skill sets of vate views of the authors and are not to be construed
paramedics, rearward medics, and physician assistants as official or reflecting the views of the Department of
such as at casualty collection points, battalion aid sta- Defense or US Government. The authors are employees
tions, vehicle ambulances, and helicopters. Although the of the US Government. This work was prepared as part
science has been slow in demonstrating this point on of their official duties and, as such, there is no copyright
user-tool specificity, awareness of it remains low in the to be transferred.
operational medicine community.
Disclosures
The limitations of this study include that the experimen-
tal design was not of clinical care, and having one ex- The authors declare no conflicts of interest.
pert user, which limits generalizability of findings. The
study was not primarily intended to show the capacity References
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/the-press-office/2015/10/06/fact-sheet-bystander-stop-bleed
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28 Journal of Special Operations Medicine Volume 15, Edition 3/Fall 2016